Rhythmic Physician: Aching Fingers

Repetitively gripping drum sticks or striking a drum with our hands can lead to a number of hand injuries, all of which can eventually lead to arthritis. The position in which we hold our sticks, traditional versus match grip, can also predispose us to stress across various joints and tendons of the fingers, which can lead to pain, tendinitis, joint capsule laxity, and eventually arthritis.

Osteoarthritis occurs when cartilage in our joints wears down and can affect any joint, though it most commonly affects the small joints in our hands, hips, knees, and spine. It typically affects just one joint, though in some cases, such as with finger arthritis, several joints can be affected. The most common portion of the hand affected is at the base of the thumb, known as the metacarpal phalangeal joint or basal joint.

Osteoarthritis symptoms often develop slowly and worsen over time. Signs and symptoms include pain in a joint during or after use, or after a period of inactivity, tenderness in the joint when light pressure is applied, joint stiffness that may be most noticeable after periods of inactivity, loss of flexibility limiting the ability to grip, a “rice krispy” or grating sensation when the joint moves, bone spurs causing hard bumps around the effected joints, and swelling in the fingers of the hand. Osteoarthritis occurs when the cartilage cushion at the ends of bones in our joints deteriorates. The smooth friction-free surface of the cartilage becomes rough, causing irritation. Eventually the cartilage wears down completely, resulting in bone rubbing on bone and causing the ends of the bones to become damaged and painful. When this develops in a drummer, quick evaluation by X-ray is required to prevent further deterioration of the joints.

Treatment will depend on the severity of the symptoms, as well as the clinical impairment to which these symptoms can lead. Once the diagnosis is made, non-surgical treatment begins, including anti-inflammatory medications, ice, bracing, occupational therapy, and possibly injections with corticosteroid medications. However, when pain becomes severe, or does not respond to conservative measures, surgical treatment may become necessary.

It is imperative that we care for our hands and treat even the most minor of injuries aggressively. When a problem develops or is identified, quick effective evaluation and treatment can help minimize the lasting effects of these injuries.